舌側皮質骨を温存した下顎臼歯部垂直的仮骨延長法についての検討 Vertical distraction osteogenesis with preservation of lingual cortical bone in the posterior mandible : Preliminary report
This study evaluated the usefulness of vertical distraction osteogenesis (VDOG) using a non-vascularized bone fragment prepared by an osteotomy with preservation of the lingual cortical bone in the posterior mandible. Thirteen surgical sites in 9 patients with insufficient vertical bone height were treated by means of a track-type distractor. After a two week latency period, distraction was started, and after 8 weeks of consolidation the distractor was removed. Four weeks later, fixtures were placed in the distracted regions. Radiological evaluation was carried out with CT images, taken before implant surgery and after removal of the distractor. Vertical bone height and CT values were analyzed. Distraction effect and bone formation were evaluated on cross-sectional dental CT images. Bone formation was clinically evaluated at each surgical point. Distraction ranged from 2.7 to 9.2 (mean 5.03+/-1.66) mm, and CT value ranged from 102.5 to 160.3 (mean 127.4+/-21.1). As for the surgical findings of bone formation, fixtures could be placed in almost all distraction regions, except for two cases of immature bone formation that required minor secondary bone grafts with simultaneous fixture placement. Bone formation promoted by VDOG with a free bone fragment was similar to that with conventional methods despite the temporary arrest of blood supply. We concluded that VDOG with preservation of the lingual cortical bone plate reliably augmented vertical bone for implant treatment in the posterior mandible.
日本口腔外科学会雑誌 52(12), 689-699, 2006-12-20
Japanese Society of Oral and Maxillofacial Surgeons